Common use of Quality Management Overview and Definitions Clause in Contracts

Quality Management Overview and Definitions. 7.1.1 Contractor shall monitor, evaluate, and take effective action to identify and address any needed improvements in the quality of care delivered to its Attributed Members by all providers, including specialists, in all types of settings, in accordance with the provisions set forth in the Contract. Contractor shall submit quality improvement data in a time and manner as set forth by DVHA including, but not limited to, data that meets Healthcare Effectiveness Data and Information Set (HEDIS®) standards for reporting and measuring outcomes. 7.1.2 Additionally, Contractor must submit information requested by DVHA to complete DVHA’s annual quality strategy plan. This will include the results of any performance improvement projects or quality improvement projects. For purposes of this Section, a quality improvement project is a planned strategy for program improvement and is incorporated into Contractor’s quality management and improvement program work plan, and a performance improvement project is a planned strategy for program improvement which adhere sot CMS protocols for performance improvement projects.